Anaphylaxis/Allergic Reactions

Question 1

What is Anaphylaxis?

Answer 1

• An acute life threatening reaction characterised by a rapidly deteriorating airway and/or breathing and/or circulation problems

Question 2

Mild/moderate signs of allergic reactions?

Answer 2

• Swelling of lips/face/eyes
• Hives or welts
• Tingling mouth
• Vomiting
• Abdominal pain

Question 3

Signs and symptoms of anaphylaxis?

Answer 3

• Any one or more of the following indicate anaphylaxis
• Difficult or noisy breathing
• Swelling/tightness in the throat
• Wheeze or persistent cough
• Difficulty talking and/or hoarse voice
• Persistent dizziness or collapse
• Pale and floppy (young children)

Question 4

Treatment for mild moderate allergic reactions?

Answer 4

• Fexofenadine

- Reassess for improvement and monitor for signs of anaphylaxis

Question 5

Treatment for Anaphylaxis

Answer 5

• Do no let the pt walk or stand - place pt supine for hypotension
• Adrenaline is front line treatment - do not delay this for any other treatment
• Compound sodium lactate
• Glucagon
• Salbutamol
• Hydrocortisone
• Nebulised adrenaline

Question 6

Adult dose for Adrenaline in Anaphylaxis

Answer 6

• IM Adrenaline: 500mcg of 1:1000, repeat 5min, no max dose
• After 4 IM doses, consider ICP for IV adrenaline infusion
• Nebulised adrenaline can be used after IM if continued upper airway obstruction: 5mg neb of 1:1000, repeat every 30min, nil max

Question 7

Adult doses for other drugs in anaphylaxis

Answer 7

• Compound sodium lactate: IV 20mL/kg nil max while indicated
• Salbutamol: 5mg Neb, nil max, repeat while indicated
• Hydrocortisone: IM/IV 100mg, nil repeat